For hip pain the location, depth and aggravating factors help us diagnose the injury. The 3 hip issues we see and treat regularly are lateral hip pain (aka hip bursitis/tendinopathy), hip impingement and arthritic hip pain.
Lateral hip pain
Lateral hip pain is experienced around and behind the hip bone (greater trochanter). Often the pain is referred down the thigh towards the knee. It can sometimes be difficult to differentiate this from referred back pain, however, the pain provoking activities usually give it away. Lateral hip pain is usually aggravated by walking, stairs, sleeping on your side and sitting with the legs crossed. Stretching is often prescribed but more recently we are finding that this can also aggravate the condition, increasing the compressive force on the gluteal tendon. In recent years research has established the condition is likely caused by compression of the gluteal tendon. Through this research we now have established best practice for the treatment of this condition which includes education on postural faults, releasing tight hip musculature and a graduated exercise program to drive/ initiate a healing response in the tendon.
Anterior hip pain
With increasing participation in gym activities requiring extreme ranges of motion (like deep squats) incidence of hip impingement is on the rise. There are several factors that may predispose to hip impingement and these include: the shape of your pelvis, poor squat technique and muscle imbalances around the hip. Pain is usually felt in the front of the hip or groin and it is exacerbated movements that require deep flexion like sitting, squats or cycling. There is some debate on the exact mechanism of pain with hip impingement, but it is generally accepted that there is some abutting of the thigh on the front of the pelvis which can lead to inflammation or cartilage injury. This is an injury that must be respected as when neglected it can lead to the development of arthritis. Treatment is focused on correcting both pelvic tilt and muscle tension of the adductors, quadriceps and gluteals.
We also commonly see inguinal hernias, osteitis pubis, osteoarthritis and avulsion injuries which all cause their own variations of hip pain.